社区老年多重慢性病患者健康相关生命质量及其影响因素分析

Health-related quality of life and its influencing factors in elderly patients with multiple chronic diseases in community

原田甜 ¹周俊阁 ¹李国鑫 ¹刘安琪 ¹贾蕙冰 ¹张浩 ¹李润鑫 ¹张洪剑¹

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作者信息

1. 郑州大学公共卫生学院社会医学与卫生事业管理学教研室郑州 450001
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摘要

目的:探讨社区老年多重慢性病患者健康相关生命质量(HRQoL)状况及其影响因素.方法:采用多阶段分层整群抽样方法,选取青岛、广州和苏州3 个城市辖区内6 个街道社区老年多重慢性病患者(≥60 岁),对其社会人口学特征、行为生活方式、慢性病患病情况和HRQoL等进行调查.对不同特征老年多重慢性病患者健康效用值进行单因素分析,采用Tobit回归对健康效用值影响因素进行分析.结果:老年多重慢性病患者总体健康效用值为0.847(0.569,0.939).EQ-5D量表中疼痛/不适维度存在健康问题的比例(45.8%)最高.已婚(β=0.049,95%CI为0.000～0.098)、子女或孙辈每天探望(β=0.074,95%CI为0.022～0.126)的老年多重慢性病患者健康效用值较高;年龄≥80 岁(β=-0.067,95%CI为-0.119～-0.016)、患3 种慢性病(β=-0.045,95%CI为-0.087～-0.004)和4 种及以上慢性病(β=-0.092,95%CI为-0.137～-0.047)、每天睡眠时间≥8 h(β=-0.098,95%CI为-0.149～-0.046)、居住方式为福利院/养老机构/保姆/护工(β=-0.086,95%CI为-0.148～-0.023)、主要经济来源为家人提供(β=-0.116,95%CI为-0.229～-0.002)、子女或孙辈1a及以上探望1 次(β=-0.122,95%CI为-0.234～-0.009)的老年多重慢性病患者健康效用值较低.结论:老年多重慢性病患者HRQoL较差,疼痛/不适是主要健康问题,需探索更有效的慢性病管理模式,以更好地改善老年多重慢性病患者HRQoL.

Abstract

Aim:To explore the health-related quality of life(HRQoL)status of elderly patients with multiple chronic diseases in community and its influencing factors.Methods:Using multi-stage stratified group sampling method,6 street community elderly patients(≥60 years old)with multiple chronic diseases from Qingdao,Guangzhou and Suzhou were se-lected for their socio-demographic characteristics,lifestyle,chronic diseases and HRQoL status.The health utility value of elderly patients with multiple chronic diseases with different characteristics were analyzed by single factor analysis,and the influencing factors of health utility value were analyzed by Tobit regression model.Results:The overall health utility value of elderly patients with multiple chronic diseases was 0.847(0.569,0.939).In the EQ-5D scale,the pain or discomfort di-mension(45.8%)had the highest proportion of health problems.Elderly patients with multiple chronic diseases who were married(β=0.049,95%CI 0.000-0.098),visited by children or grandchildren every day(β=0.074,95%CI 0.022-0.126)had higher health utility values.Elderly patients with multiple chronic diseases aged≥80 years(β=-0.067,95%CI-0.119--0.016),with 3 chronic diseases(β=-0.045,95%CI-0.087--0.004)and4 or more chronic diseases(β=-0.092,95%CI-0.137--0.047),sleeping 8 or more hours per day(β=-0.098,95%CI-0.149--0.046),living in welfare home/nursing home/nanny/nursing worker(β=-0.086,95%CI-0.148--0.023),mainly supported by the family(β=-0.116,95%CI-0.229--0.002),and visited by children or grandchildren once a year or more(β=-0.122,95%CI-0.234--0.009)had lower health utility values.Conclusion:Elderly patients with multiple chronic diseases have poor HRQoL,pain/discomfort is the main health problem,and more effective chronic disease manage-ment modes need to be explored to better improve HRQoL in elderly patients with multiple chronic diseases.

关键词

社区老年人/多重慢性病/健康相关生命质量/EQ-5D量表

Key words

community elderly/multiple chronic diseases/health-related quality of life/EQ-5D scale

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基金项目

国家重点研发计划项目(2020YFC2006100)

出版年

2024

郑州大学学报(医学版)

郑州大学

郑州大学学报(医学版)

CSTPCD北大核心

影响因子：1.246

ISSN：1671-6825

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